CEFTRIAXONE

Antibacterial activity

Cephalosporin, third generation
Effective against most gram-negative 
Gram-positive coverage
Anaerobic coverage (no C. difficile coverage)

Pregnancy Risk Factor

Class B

Contraindication/Precaution

Hypersensitivity to ceftriaxone, other cephalosporins or any component
Use caution if previous penicillins hypersensitivity:  10% of patient may have cross-hypersensitivity to cephalosporins
Use caution with nursing mothers
Use caution if seizure disorder
Use caution if renal/hepatic dysfunction or if other nephrotoxic agents present
Use caution if hyperbilirubinemia
Use caution if history of ATB related colitis

Mechanism of Action

Inhibits cell wall synthesis (bactericidal)

Pharmacodynamics

Metabolism: N/A
Half-life: 5.8-8.7 hours, changes with renal/hepatic function
Elimination: excreted mostly in urine and some in feces (bile)

Dosage

Children: (max 2 g/day)

Body weight < 2000 g 0-7 days old: 50 mg/kg IV/IM qd 8-28 days old: 50 mg/kg IV/IM qd Body weight > 2000 g
0-7 days old: 50 mg/kg IV/IM qd
8-28 days old: 75 mg/kg IV/IM qd
> 28 days old: 50-75 mg/kg IV/IM qd (100 mg/kg qd for meningitis, max 4g/day)

Adults: (max 4g/day)

1-2 g IM/IV qd or div bid
N. gonnorrhea infections:
250 mg IM x 1

Dose VS renal function

Cr. clearance (ml/min):
<10: unchanged 10-50: unchanged 50-80: unchanged >80: unchanged

Dialysis
Hemo: none
CAPD: 750 mg IM/IV q12h